Provider Demographics
NPI:1437325263
Name:TAYLOR, SUSAN L (CRNP)
Entity Type:Individual
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First Name:SUSAN
Middle Name:L
Last Name:TAYLOR
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:12510 PROSPERITY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1663
Mailing Address - Country:US
Mailing Address - Phone:240-485-5200
Mailing Address - Fax:301-625-6906
Practice Address - Street 1:3280 URBANA PIKE
Practice Address - Street 2:SUITE 204
Practice Address - City:IJAMSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21754-9406
Practice Address - Country:US
Practice Address - Phone:301-810-5252
Practice Address - Fax:301-810-5255
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2016-07-11
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Provider Licenses
StateLicense IDTaxonomies
MDR090382363LA2200X
DCRN1029416363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health